• Karen McPhail

Planning is Key - Consider a Covid Plan for Care!

In an effort to be proactive during a time of some downward Covid trends, it is time to perhaps consider and begin to develop a Covid Care plan in preparation for a potential fall and winter spike.

This is especially important for those with chronic conditions of all ages!

The following areas need to be addressed when planning:

1. Think about what is most important in the event that you become seriously ill. Think about what you would like to be done and what you would not prefer to be done in terms of care and treatment. In an effort to keep decisions from becoming overwhelming, it is best to focus on your overall goals first and then form specifics as they apply. Independence, aging in place, family support, pain management, and quality of life need be focused on.

2. Chose an individual who can be your health care decision maker if you become too ill to care for yourself. This person is called a medical power of attorney, health care proxy, or health care agent and will need access to your medical health information. Pick one individual with ideally a back up so that decision making is timely and effective if needed. This individual will be acting on your expressed wishes so again details are important. Choose someone who understands your needs and wishes and someone you can trust to act on your wishes effectively. This person needs to be willing to make decisions for you based on your beliefs and wishes, not theirs.

The health care agent should be able to effectively and clearly communicate with authority figures such as care managers, discharge planners, care communities, and physicians. Being a person who is comfortable with decisive actions is an important trait in a health care agent, as medical decisions often need to be made timely.

Transparency of information is then key after choosing a health care agent - it is important to let others know your plans so that appropriate parties understand your expressed wishes and any specifics. Transparency of information also often prevents potential family conflict.

3. Talk about care planning with your designated health care agent. Consult an RN Care Manager who can often assist with this aspect as a clinical expert. Understanding your current health situation, any chronic conditions, family dynamics, lifestyle, culture, religion, support system, your past experiences, hobbies, socialization and activities, and your intellectual interests helps individuals to make effective decisions that are consistent with your expressed goals and wishes. Tell your health care agent who you would want them to contact should you become ill. End of life and funeral planning aspects should also be discussed over time and planned for.

4. Ensure that you have a Home Medical Record. This should include a list of your past and current health conditions and diagnosis, allergies, past surgeries, medications with dosage and frequency, and physicians and any associated clinical support staff involved in your care (homecare, PT, OT, etc). Although the electronic clinical record is in place in most medical centers there are often errors and omissions. In addition, emergency personnel need to be aware of all aspect timely if needing to intervene. Keep copies of your insurance cards, ID, and power of attorneys along with your medical record in a binder. It is important to have all health care information and power of attorneys in a binder, that is easy to locate. Ensure that your health care agent(s), care manager, and physican(s) have copies of all current documents. Email is a great way to do this, so these people can easily save your plan. A care manager can assist with these aspects if needed.

5. Make an appointment to talk with an Elder care attorney and an RN care manager to form a cohesive plan. Having a good team in place is important. It is important to see an Elder care attorney to ensure that all legal aspects are in place. A Care Manager can serve as a clinical resource and advocate long term and help to support and guide you and your health care agent. Elder care attorneys and RN Care Managers will come to you or complete consults virtually. Long term care insurance will cover most care management services. You can also obtain input from your physician(s) along the way, during regular appointments and discuss aspects as they apply to your current health and any chronic conditions. Medicare pays for appointments to manage chronic conditions and for discussing advance care plans if you are 65 or older. These kinds of appointments can be done currently via telemedicine if needed for safety. Ask your doctor and care manager if a POLST, which is more specific than an advance directive, is also right for you. A POLST does not replace an advanced directive; these documents work together in some cases.

6. Again ensure that you have transparency of information with family and other appropriate parties as this will support clarity and decrease any potential for confusion and conflict.

7. Planning is the key to success. Ensure in planning that you have an emergency plan in place for groceries, medication delivery, tele health visits, in-climate weather, etc. Consider converting to live in home care if realistic to minimize the number of individuals coming and going if at home. Have an adequate supply of routinely used items, medications, and personal protective equipment on hand for use as needed. An RN Care Manager can assist with these aspects. You can also reach out to Aging Rainbows if you need assistance. We can forward additional free self guided planning tools and checklists for use! We are here to help! Check out our resource page for inclusive service providers!

Stay safe and well!

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